The Cyclothymia Collective

2011-09-15T06:09:00.000-07:00

To say things have been quiet on the forum the last few months would be putting it lightly. A few very stalwart folk held down the ship. I am grateful to them.

Please come in and visit us, tell your stories and ask for advice or reassurance, whatever you need. This is the oldest Cyclothymia board on the Internet, with over 1300 members and 20.000 posts just about Cyclothymia. Welcome!

When it began

2010-08-11T21:55:00.000-07:00

I have downloaded the first forum (2003-2005) and have begun combing through the threads for personal accounts that I feel are representative of what I have observed to be common for most people who have visited the Collective in the years since then. I have kept the screen names, but if you would prefer not to have yours given, just let me know and I will replace it with a number, or remove your part altogether.

KatieK
I started having trouble with mood swings in the Fall of 9th grade. I knew something was wrong when I was unable to appreciate my really nice, handsome, new boyfriend-- I remember going to play racquetball with my mom on a Saturday afternoon and being in a really, really bad mood when by all accounts I "should have been" happy. Incongruous. He broke up with me a few months later. He said I was too moody.

I did not run wild. Did not do drugs or have sex. Instead I discovered that by getting really focused, by writing, I could reach a better mental state-- now I know it was hypomania-- so I guess I self-medicated with that. I played four sports a year. Read a lot.I was depressed through most of high school and felt alienated and slightly paranoid. I couldn't bear the old crowd by junior year.

CuckooBrain
I grew so angry in my junior year of high-school that I graduated early. Thats something I would not do again. Oh, and one of my friends got worried I was suicidal because of some weird poem I wrote on one of my book covers. It was cool poem though. It cycled upon itself...like the number 8, the lines had no beginning or end. Thats all I remember about it.

punkitty
I was a nerd who was into things that the kids my age could never appreciate. The kind that is friends with all the teachers. The valedictorian with a small pack of similarly weird friends. I loved to explore new philosophies and listen to music that would never be played on the radio. Rebellion with no drugs or sex. Well maybe it was more about nonconformity. And there was some drinking and maybe some contact highs.A true artist all the way, I learned to appreciate science as well.

I went through my first real bad depression in my teens. I can't pinpoint when. I think it was triggered by high school society and the abuse I took from my mother's borderline personality disorder. All things dark were soothing to me. I call it my Sylvia Path era. I read the Bell Jar twice. I got into Wicca after I rejected the catholic church. (that's over now, but learned much from it.)

Boys thought I was a freak so...not much action. My one real boyfriend dumped me in my Senior year right before Homecomming. Freekin' hate homecommings now.

Then I got in with a crowd of 40 something hippie band. I felt like I fit in there. But most of my memories of high school are clouded by the depression and the feeling of alienation. I had more fun in college when I hit my first hypomania! Yeah baby!
--you can wake up now.

kteacher
When I saw the subject of this (thread), all I could think was "painful" -- I had dreams 2 nights this week about people from high school. It was awful. Then I had ruminations about things from high school when I was awake! UGH!!!

I think I was predominantly depressed throughout high school, and when I was hypomanic I was making bad decisions that did not reflect my true character. I remember being confused about this at the time. I didn't know why I was like that. I think the depressions started at 12 when puberty hit. Before then, I was a hyper creative confident little kid. From 12-18, I was not confident at all. I HATE thinking about my teen years, so I have to stop now!!!

musiclover66
My teen years were definitely not my best. I was in trouble more than out. Was convinced that speed and pot were the way to go, in addition to alcohol and smoking. I never gave my behavior much thought until recently. I definitely had anger issues and then I had the times that there was no way life could get better and then crash back down. At the age of 17 I finally sought out counseling but could not say anything to my mother - long story - but with that constraint, the counseling only lasted like a month.

Having learned more about my illness, I now understand why I was the way I was. I always thought it was just a "teen thing" - the whole rebel concept. But looking more closely at the mood swings, the temper, etc., I see the whole picture a little more clearly.

ZZZsababa
I went through a similar through process, first thinking it was adolescence and then thinking that it was horomones. I actually thought that my birth control might be triggering my moods so I tried to keep a diary of what color pill I was on when my moods were bad.

KatieK
8th grade for me (age 14 I think). I was mildly up and down before then, but it wasn't really "different" from my friends. Then I had a deep emontional shock when I discovered my best friend had been having an affair with my first real boyfriend. I cried for days, more over her than him. It must have kicked off something, because from then on, I had clear depressive bouts, and mixed states.
amhainn
I was about 13 or 14 when things started getting bad for me - of course, it was just dismissed as teenage moodiness, hormones etc. Often wonder if I had had some positive support then, would I have gone onto develop mood swings? I sometimes feel I am just a teenager who never grew out of teenage angst [alternated with optimism] but too late now. I am who I am!

However, I started my periods when I was 11, and a few months later, went to secondary school - two huge transitions in my life and did not go off the rails till I was older - my first year at secondary school, I was this keen, hard-working, sociable child! By third year, I was cynical, miserable, angry, self-harming etc.

ttm
for me it was 6th grade that I first remember thinking suicidal thoughts. I was VERY depressed that year. I was moved from public school to private school and the change of environment was more than I could handle emotionally

Erik the frail Viking
When i was a kid i was really happy (although i remember having suicide thoughts occasionally ALL my life) and very popular. But sometime in the fifth grade, I started having this "truman show fantasy" and thought that my life was only an experiment in which everybody was pretending to like me and made everything easy for me, but were really laughing at me "the alien retarded boy." (kind of like living the life of jim carrey in truman show, except i was retarted, so everybody was acting dumb to make my life good)

when i got in the sixth grade i started "rebelling" against the hype of my peers and became more of a weird loner, still having friends, but my self esteem and popularity was dropping fast.

And then came junior high hell.. I basically stopped talking and started daydreaming. I thought everybody was phony, stupid, and uninteresting. and because of that + my shyness, i stopped paying attention to what was happening around me.(if people asked me something i would say huuh? answer their question and shut up. Often still do by the way..)

Since then, i`ve always had this weird kind of self esteem where i know that I`m Beautiful, smart, funny, musical, creative and very kind, when i`m thinking to myself. But when i need my self esteem in all kind of situations, its allmost never there. I just become self-aware and unconcentrated.

Anyways, it was in seventh grade my life started going downhill bigtime.

The forum is open

2010-05-26T21:56:00.000-07:00

I have just reopened the forum, so come on in and pull up a chair and join in on the discussions.

My plan is to revamp the blog and the new "pages" feature offered by the blog host. Because I am in the middle of my busiest time at work, this may take some time, so please understand. I feel committed to it, which is what is important.

In my experience the most important things in battling Cyclothymia are:

1. keeping a mood blog for as long as you can possibly stand it (I did three years
2. Doing your own research so you feel comfortable with all of he terminology and know what your doctor is talking about before he/she brings something up so you can be your own advocate in everything.
3. Finding or creating your own support system. Whether in person or on line, this is invaluable. Part of any mood disorder is forgetting the other moods while you are in the midst of one-- having online friends helps you keep track of your moods through posts and gives you the support you need to see that tomorrow is another day and the mood will turn.
4. Some people take meds. others don't. I am strongly pro-meds but there are others

Keeping a Mood Chart on Google Docs

2009-12-31T06:34:00.000-08:00

J., one of our talented forum members, likes to keep her data on Google.docs and then generates graphs.

I created a "form" type of survey using Google Documents (I'm a Google addict... it was just a matter of time before I figured out a way to do this.) that I can visit and fill out by visiting a link and putting in a few clicks of the mouse. I created several questions in a "scale" format, like my mood rating, level of anxiety, restlessness, irritability, etc., and some yes/no type "checkboxes."

The results automatically get stored with a time-stamp in an Excel-type spreadsheet that is also accessible through Google Documents, so it will be easy to make charts from the data without having to enter things directly into a spreadsheet. It's easy to save a chart as an image file to print, email, or even publish on a website (it creates the required HTML tags for you to copy/paste).
pdate: Just figured out how to set up a daily "charting" event on Google Calendar to send me a daily reminder to chart, with a link to the simple form to enter data.

Lithium and Creativity

2009-12-03T08:07:00.000-08:00

Many people have asked-- and I have read on other sites-- about their fears of having their creativity taken away from them by medications, in particular Lithium, so I thought I should write about my experience.

First of all, I think part of the fear comes from Lithium's long track record as a first-choice mood stabilizer. It was around when it was the only drug, except for things like Thorazine, and in the movies it is associated with people being zombies in a mental hospital. What we never hear about are the thousands, possibly millions, of people who have been helped to lead stable, happy lives with Lithium. Come to think of it, we rarely ever hear about anyone once they achieve stability. They disappear.

Before my breakdown. I was a creative kid with lots of talent who could not complete anything. I played flute, guitar and piano, learn French and German, wrote medieval adventure novels. I was a graphics major for a while at university but quickly learned that I could not depend on my creativity to feed myself (so I became a historian!!)

With this realization-- and many others-- I determined that the life of an artist was not for me and I ceased to create, or to think of myself as some day writing that great novel. My creativity still leaked out, in photographs, quilt making, the way I parent, or the way I speak Turkish.

I started my present job in 1996, three years before the breakdown. I didn't do anything there in particular besides edit.

Cue breakdown, bring in the Lithium.

Since starting Lithium I have:

--taught myself HTML and CSS
--taught myself web design using said HTML and CSS
--wrote a hand book for work and put it on the web
--learned digital photography, Photoshop
--learned equestrian photography (sports photography) and became the official photographer for the Turkish Dressage Federation
--started this website
--bought a horse
--learned to ride that horse (already knew quite a bit, but he is a very specialized kind of dancing horse)
--got bored at work and went over to another Institute, set up an editing office and trained three people to do the work.
--made their website
--made their Style Guide
--started taking freelance clients for editing
--volunteered at a foundation for the handicapped as editor of documents headed for the EU
--edited several books for professors
--become an official scribe for the national dressage federation
--Written four novels!

Almost three years ago Wellbutrin was added as my AD to see if it would help my ADHD-like symptoms and the effect was stunning. I sat down and wrote a 90,000 word novel, and then I kept going with another that was 120,000 and another at 125,000. It was AMAZING.

At work this fall I am planning to write two books on thesis preparation, redo the website--- and I have no doubt that I can do these things here before I would have know nit was hypmania speaking and that I would forget all about these things.

I am not hypomanic. I am just: creative.

Medications have done wonderful things for my productivity. I won't lie. It can take some time to get used to and you might have to play around with the add-on meds (Anti-depressants, anti-convulsants, etc).

I can create today and I know I can create tomorrow. It feels really good!

On the Forum, four of the active members are on Lithium. Three of us committed to doing NaNoWriMo, an online event where participants pledge to write a 50,000 word novel in 30 days. It is a lot of fun and I strongly recommend it. I had done it twice before and succeeded. S. and J. had never written novels before. We all wondered how it would go since they both had recently started Lithium. Well, all of us succeeded. Very happy about that. Here are some excerpts from a discussion we had on the forum about Lithium and creativity:

From the Forum:

S.: I'm feeling the same way after being on lithium for only about a month or so.

I'd have to say that the creativity I feel is better and more long-lasting than I ever had before. It's exciting! I never realized I had so many good ideas in my mind, nor the actual ability to get things done. It's a real self-confidence booster, being involved in the creative process. I feel like an artist. Writing is an art, so I am creating art.

I have a short list right now. Since starting lithium, I wrote nearly 5000 words in planning for my novel, and committed to doing NaNo for November. For under two months, that's pretty good. And bonus, I haven't had a mood swing so that certainly helps everything, creativity included.

KatieK: 5000 words in planning is fantastic. The most important thing is that you are not "waiting for the muse" and then blindly setting out to writ, just setting yourself up for the mood to shift and then for yourself to fail, as always (at least in my case). You are creating a road map and planning for contingencies (like FORGETTING) and setting out with confidence.

I do not think it is "if" you will finish NaNo, it is "when".

I bet we both write more than a thousand words on this board every day-- it only takes 1660 words a day.

S.: That's it. I'm not waiting for the muse.

I have a brain that works better now and so I can create better.

I can do 1660 words a day. I have probably done single POSTS on here that have been that long.

The difference was that for me, the length was from hypomania before. Now it is because the story is so engaging and my mind can remain engaged, not just here and there. It is very cool.

I have no idea if the story I am writing will be any good either, but I feel the same, the process is such a great experience. I feel strong and inspired (at least in the writing arena). It is real joy. My mind wasn't ready for it before lithium or meds in general. Now, writing is a bonus, and a motivator to get even more stable...so I can write more.

I'm wondering if the idea of lithium affecting creativity has to do with hypomania. Lithium does a good job to prevent the ups and downs of a mood. It's very effective at getting rid of hypomania too I have noticed. I wonder if the myth really lies in hypomania as the 'creative state', and that's the myth we're kind of working to dispel as lithium users here.

That would sum up what I have learned so far about creativity on lithium--creativity doesn't just occur in the hypomanic state.

Maybe the idea that creativity disappears when lithium is started is also rooted in the BP'ers insecurity of their own moods, the inability to predict what mood will be next. Then, if the ideas come forth in the hypomanic state, we learn that we're 'only' creative in that state. Actually, we're just hypomanic and we can't tune into our creative ideas in any other state because we're in the throes of a mood swing.

There is a period of hypomania that is 'happy' and I think we feel good. The rest of the mood swing, if you're going back and forth all the time, is unpleasant, at least in my experience. Maybe there is even a creative component to the lows of depression too.

So, I have been considering the last few days that maybe the myth that lithium kills creativity is really the myth that someone with BP can only be creative in the extremes of a mood.

Lithium got an unnecessary bad rap because it gets rid of the two things that idea is based on, the highs and lows.

Cyclothymia

2009-08-31T13:58:00.001-07:00

Cyclothymia it is part of the Bipolar spectrum. People often come into the forum and say, "I don't know if I am Cyclothymic or Bipolar." Cyclothymia is a version of Bipolar Disorder.

It's called Bipolar III in the classification books. It is treated sometimes with talk therapy, but it is more commonly treated with serious psychotropic, mood stabilizing drugs like Lithium and Topamax. To respond to those who say that Cyclothymia is not really an illness, I say that it seems a sure indication that Cyclothymia is an illness if it requires these kinds of medications to treat it.

It might be that its symptoms are not as full blown as in BPI and BPII as to require hospitalization, for example, but it certainly disrupts our lives and causes us enough pain that we feel compelled to seek professional help and support on the Internet.

My psychiatrist says Cyclothymia is part of the BP spectrum and that a specific label for it is meaningless as everyone experiences it differently, many people go on to develop BPI or BPII later on in life, and the treatment is nearly identical to that for BPI or BPII. What is
important is to establish whether you are on the spectrum at all, not
where you are on it.

More important than if other people take you seriously is whether you take yourself seriously.

Guidelines

2009-08-09T06:10:00.000-07:00

Bipolar Disorder is a spectrum disorder and it is difficult to tell where one form starts and another one ends.

Everyone is welcome to join in and participate. If you know you are BP1 or BP2, you are welcome to come in, please keep in mind that it is a Cyclothymia forum. You may join in the conversations, but I ask that you not post about medication regimes. If enough people with BP1 and BP2 are interested, I can open a section for you to discuss medications. I really want to have a "clean" record of what works and does not work for Cyclothymics.

I reserve the right to warn people with BP1 or BP2 if I think the discussion is getting pulled away from Cyclothymia and into your problems regarding your doctors and your medications that involve your denial of reality and delusions that you know better than your doctor. This is the greatest area where BP1/2 people differ from Cyclothymics.

The line between Cyclothymia and BP1 and BP2 remains blurred and we will just have to be comfortable with that.

Online Tests for Bipolar

2009-05-11T00:25:00.000-07:00

On the forum in the last few months people have been taking two online tests for bipolar disorder:

The Goldberg Bipolar Screening Quiz at Psych Central

Bipolar Disorder Self-Test.

This has been interesting. I have taken each at least three times, at different stages of my treatment, at "semi,stable", "pretty much stable" and today, at "stable", and each time I thought the tests were accurate (although it must be noted that the Black Dog test only screens for manic symptoms, so it is not a true "Bipolar" test). I scored somithgn like, 45, 18, and now 1 on the Psych Central Test.

Most of the other people on the forum who have taken the test scored in the 30s to 40s (moderate Bipolar to serious) and said either "I must be worse off than I thought" or flat out "This is wrong." A few people have agreed.

I suspect that most of us have been dealing with this for so long that we either minimize it or deny it is as bad as it is.

Are the tests accurate? I think so. Should you show them to your doctor? You should bring it up. You can say, "I was on an online forum for (depression, mood disorders, whatever) and we all decided to take some online tests and compare scores. Out of x points, I scored y on the Bipolar test. The Bipolar people in the group scored about the same as I did. I know it's just an online thing, but I wanted to bring it up."

I did this with ADHD. I knew my pdoc had no training in it. There us only one specialist in this country and it is not him. He thought it was worth considering since most of the other people scored under 50 and I scored 83.

Neurodiversity website

2009-02-09T01:55:00.000-08:00

I just came across this website: Neurodiversity.com. It sadly has nothing about Bipolar as far as I can tell. It has tons on autism and other conditions and a wealth of links to how to deal with being different, how to cope, etc. I suspect that much of it overlaps with Bipolar. I'll be working my way through these links and will report on what I find.

Cyclothymic Moods

2008-12-31T04:08:00.000-08:00

I was playing with the chart options in Word 2008 and made this. I think it is an accurate description of how I experience Bipolar Disorder, with hypomania on top, depression on the bottom and the mixed state in the middle. Stable is there at the base, holding things together. Not terribly earth shattering, but it shows that the mixed state is at the center of the experience. People seem to be able to muddle through with depression for years, and they enjoy being hypomanic. It's when things start getting mixsy that they go in for help. Because it really is insufferable. It is what makes us mess up marriages, lose friends, lose jobs, turn to alcohol and other drugs, take unwise risks, think about killing ourselves. So why do so many people who visit the forum seem surprised to learn that there is a third mood? So I'm putting it right dab center for us all to stand back and admire.

What is "depression" ?

2008-12-18T05:57:00.000-08:00

In reply to a forum post on a site about something entirely different, I wrote this:

I agree that the statement "depression is misunderstood" is true.

Most people think depression can be defined as "you are down about something for a while, then you pick yourself back up." This kind of depression does not require professional help, or it might respond well to behavioral therapy.

The depression that requires chemical assistance and does not respond to talk therapy is something else.

It is a neurological condition involving things called reuptake inhibitors, basically resulting in an inability to absorb seratonin or dopamine. Trouble with these hormones can lead to feeling depressed, but in the French form of the word, "lacking pressure", or impulsion in life. It results in reduced feeling, reduced interest in life, an inability to create or engage in planning, or even just give a shit. It might lead to suicidal ideation, or even suicide. 25% of people diagnosed ith Bipolar Disorder attempt suicide at least once.

It's okay to say, "My boyfriend left me, I'm depressed, boo hoo hoo," but try saying, "I am still grieving the death of my father five years ago." Unfortunately this second kind shares a name with the first. What if the lack of feeling, the suicidal ideation were called, for example, Woolf Syndrome (after Virginia Woolf, who is a well known depression victim)? "I am receiving treatment for a neurological condition called Woolf's Syndrome" would find a more sympathetic audience than "I am receiving treatment for depression."

Kind of Mixy

2008-09-11T00:20:00.000-07:00

I've been very busy at work, editing, editing and doing more editing. This is the first year my brain hasn't gone completely fried as a result. I credit the Wellbutrin.

I am, however, noticing that I am entering into a mixed state. It's not that I have been hypomanic, just really focused for six weeks and now that I am reaching the end of the pile, I am starting to come down.

Here's how I feel:
I feel like I have a slight buzzing in my body.
I'm concerned about the neighborhood (peaceful neighborhood, no reason for fear)
Worried about work, political stuff...when there really are none
Am of the opinion that what I do is bullsh*t.
General anxiety.

It's mild, but they are all there. Time to break out the Xanax. I estimate another three days of heavy work and then I can do some relaxing....unless one of my other bosses decides to dump on me :P

Lithium and creativity

2008-03-20T09:47:00.000-07:00

I have had the nicest week. No work at the office, so I have been riding my horse and working on my NaNoWriMo novel re-write. I may have mentioned before that while I wrote compulsively as a teenager, I had never finished a piece of fiction before this. I stopped writing fiction in college and turned to technical writing. NaNoWriMo was great because I had to complete a 50,000 word novel in 30 days. And I did it, with two days to spare.

Never having finished anything before, I have no experience with rewriting a piece of fiction. I had no idea that it could be so engrossing, and so much fun. I just came to the part where the main characters have to part and I got choked up. Silly, but true. And surprising.

A whole new world is opening up for me. I have always been creative. I have made quilts and had photographs published, designed websites, and done other thingsbut none of them has been as exciting as this.

When I was 7 years old my father brought home his Smith-Corona typewriter and I fell in love. I started writing plays and then advanced to longer pieces, some of which I did finish...but when the BP kicked in around 8th grade the writing ceased to be a reasoned activity and became a love-hate-addiction kind of relationship. I was in the habit of writing, but went through periods when I couldn't write, and then doubted everything I had written. And then in college I just gave up. It was just too hard.

Twenty-five years have passed. I've been on Lithium for eight years now. The general bellief is that Lithium will kill your creativity, but I am no so sure about that. In these eight years I have taught myself web design and have created websites for work, charities and hobbies; I have gotten reinvolved in photography and learned a great deal about Photoshop; I have bought a horse and started to learn the complex discipline of dressage, and now...now I am rewriting MY NOVEL.

It may not be a great novel, but it is MY NOVEL. It is something I had given up planning or hoping to do. Having evidence of this thing which for so many years I wanted to do but was unable to do, is thrilling.

I owe it all to being on meds. Maybe other mood stabilizers can do the same for people; Lithium has done this for me. I wanted to write about my experience with it in order to put a positive story about it out there to let people know it can happen. Lithium doesn't mean saying goodbye to creativity.

In a lecture in 2000 at the Manic Depressive Association of Boston (highlights of lecture here "Dr. Frankenberg presented a study of bipolar artists that were asked how their creativity fared now that they were taking lithium. One-third said their creativity was great, one-third noticed no difference, and the remaining one-third thought it had suffered."

At last....

2008-03-13T04:08:00.000-07:00

I felt my mood rising this morning and pop into what I think of as its proper place. Cycle complete.

The Perils of BP Blogging

2008-03-11T21:57:00.000-07:00

I forgot all about you. Well, not entirely, but I have had no interest in posting. I've gone from the Mixed State of ten days ago to a subdued, but anxious and tired, BLAH. I cling to the present and can't think of the past. The recent past was painful. While I no longer feel shame at having lost control (diagnosis helped this tremendously) I feel it is best not to look back but to concentrate on the present, which I can handle, and a tiny bit of the future.

I am fortunate to have a job that I am able to do (editing) not matter what my state. When I am hypomanic it can be a bit tedious, but when I am like this, it is my life preserver. The mechanical checking of each sentence for accuracy and meaning, and the information enclosed in each one, is calming, and reassuring. After I completed the final draft of the manuscript of an academic journal I have been editing for 8 years and was delivering it to my boss, however, my general level of anxiety turned into a slight and constant feeling of panic...when I had no reason to feel so. My work is solid. My boss (a woman) loves me, we are a good team. It may have been that after having focused intensely to finish the draft, I set off a bit of hypomania, which ramped up the anxiety.

I am also editing the novel I wrote during NaNoWriMo (National Novel Writing Month). This has been interesting on a few different levels. This was my first NaNoWriMo attempt, and I succeeded beyond my wildest expectations. I hadn't written any fiction in about 25 years. I could never finish anything. I credit Lithium entirely for making creativity possible for me. I had no idea how it would go, but it really flowed and I found the 1663 word daily minimum to be easy to reach. I was not clearly hypomanic during that time. I had been planning to write about a cholera epidemic in Istanbul in the 19th century, but a huge pile of work arrived the last week of October and I considered not doing it at all. Then my daughter said, "Write Harry Potter fan fiction!" and that seemed like comforting escapism,so I wrote about the HP world, but set in a school in Istanbul.

So now I am revising. This was fun while I was in a Mixed State-- I think I liked the escapism of it-- but now I feel it's tedious, which is a shame since my characters deserve better.

This is an account of how my attention ebbs and flows with my mood swings. As I said above, Lithium has made it possible for me to do this. Just the fact that I am editing my own work-- I have never been able to do that (besides web writing) because I was never able to finish anything. It is great fun, tweaking the sentences, adding nuance. I now see what writing is, where the craftsmanship comes in. Before, I thought writing was about riding the hypomanic beast, waiting for "inspiration" to guide me. The process was mysterious and...well, I produced nothing. Now it seems I can write when I like, with only small ups and downs. It's very exciting. Editing the manuscript is engrossing, not in the way the writing was, but in the process of fixing holes in logic and trying to give life to the dialogues.

Next year I want to write something all my own. When I tell people I wrote a novel, they go "Oooooh, wonderful!" and when I explain that it is HP fan fiction, the go blank. I'm taking notes on the epidemic (actually my MA thesis was about contagious diseases in the 19th century Ottoman Empire).

So, you see, I am fine, just turned inwards. At this point in the game, maintaining my friendships is very difficult because I don't think of my friends at all, or if I do, it is with anxiety, worrying that I have ignored them for too long, worrying that I am not attentive enough, which makes me feel like throwing in the towel on everything. I feel the same way about blogging.
Right now I am debating whether I should go riding. I agreed with a friend to take our horses out into the hills for a couple of hours today, but I am feeling so indifferent, which shows my state of mind because I LOVE riding outdoors. Maybe the air would do me good. My anti-social impulses never involves animals. Unless it is my Siamese cat trying to climb into my shirt while I am trying to type. We've started leaving the heat off except for the evenings, so she she views me as the next available heating system.

On the downturn

2008-02-25T09:05:00.001-08:00

This is why I hesitated for so long to turn the website into blog format, but maybe I can turn it around and give it some positive value. For the last few weeks I have been feeling great (but not too great) and then a couple of days ago I began to notice that I was losing my patience, losing my morale, and offhand comments people made to me were haunting me to a degree all to familiar. Perhaps because my high was not too high this time, maybe thank to the new anti-depressant I have started, the crash won't be so bad...

But still, I am sick of myself, sick of the world and aggressive to boot. Stay away from the car. Also I am horrified by everything I have said or written online. Even though I never divulge much about myself-- for precisely this reason. I think I developed an obsessive secrecy for this reason. I never want to say anything that might come back to haunt me...only in this state of mind, everything seems like crap.

I know I will feel better in a matter of time even though I have nothing but a vague memory of having been up and happy...sigh...I feel I am not explaining it adequately.

I write this to make a record of a Cyclothymic's experience.

My psychiatrist says I have no need for talk therapy as I don't have any issues. I put it that way so it has credibility :) I had no childhood traumas, no negative sexual experiences, nothing. So when I feel bad about the past, it is over stupid little things. I can't even begin to imagine what it would be like to be Bipolar on top of PTSD, for example, or to have been abused. It must be like being thrust down into one of the rings of Hell in Dante's Inferno,left to roast over a slow fire. I don't think I can exaggerate too much.

If anyone reading this would like to contribute with their own story or take on Cyclothymia, I would be very happy to post it. I believe the more stories we tell, the better. It can only help us as a population.

If you are feeling totally crappy and just want to whine on and on about it, in our forum we have a section called the Whine Yard, where you can get it out of your system by writing about it and no one can suggest a fix or tell you to snap out of it. Sometimes we all need to barf it all out down a very deep well. We also have an anonymous section, where you can log out and then log back in using the anonymous account set up just for this-- for people who want to get the really dark stuff out.

I always feel better after I post on the forum. I know my forum-mates understand me and will support me. It's good to know we are not alone.

Treating the mixed state

2008-02-21T00:57:00.000-08:00

A small study conducted in 2007 by Pasquini et al. reported on by Health Central.com looked at treatment of the mixed state (dysporia).

They began with the assumption, made decades ago, that the mixed state, while linked to depression, requires separate consideration during treatment. Pasquini et al. state that "depression plus anger or aggression is almost as common as depression with anxiety, the researchers point out.."

As far as I have found in the world of Internet sites on Bipolar, symptoms such as anxiety are put together in the category of mixed state. However, it is in agreement with a study from 2000 by Dayer et. al, saying "we describe in addition to the DSM IV mixed state (type I) two new subtypes of mixed states (type IIM and IID). This new typology can give the clinician a more accurate understanding of the complex and polymorphous reality of mixed states." (I was unable to find any more data online about IIM and ID).

The researchers postulated that since serotonergic pathways seem to play a role in aggressive behaviors, perhaps patients would benefit from a selective serotonin reuptake inhibitor (SSRI). To that they added an anti-convulsant, on the theory that anticonvulsants affect GABAergic and glutamatergic pathways.

The subjects were treated with an SSRI plus an anticonvulsant (usually valproate) for 12 weeks.

Result: Treatment with the two-drug regimen was associated with a significant improvement in depressive symptoms. In addition, marked improvements in anger or irritability and anxiety were noted. Eighty-two percent of patients were rated as improved or much improved on the Clinical Global Improvement scale, the authors state.

Here are lists of SRRIs and anticonsants:

Common SSRI brands
citalopram (Celexa, Cipramil, Emocal, Sepram, Seropram)
escitalopram oxalate (Lexapro, Cipralex, Esertia)
fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin (EUR), Fluox (NZ))
fluvoxamine maleate (Luvox, Faverin)
paroxetine (Paxil, Seroxat, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)
sertraline (Zoloft, Lustral, Serlain)
dapoxetine (no known trade name)

Anticonvulsants
Carbamazepine (Epitol, Tegretol)
Clonazepam (Klonopin)
Valproic Acid (Depakene, Valprotate)

In the list of Bipolar meds at psyweb.com,these are only five of the standard 21 non-antidepressant medications approved for treatment in Bipolar Disorder, so be careful.

In the aftermath

2008-02-21T00:05:00.001-08:00

One thing that always gets me with a mixed episode is how shaken I feel afterwards. It's a life-altering event, no matter how mild the episode. For however short a time, I was questioning my sanity, my existence, my ability to go on. Now my "normal" life seems somewhat alien and will take some getting used to. It's like having been away on a very bad holiday...

Suicidal ideation

2008-02-20T13:02:00.000-08:00

Talking about suicide and even suicidal thoughts are taboo in our society, but the fact is that these things are part of the Bipolar experience. Citrome and Goldberg state that, “it is a myth that asking about suicide places the idea into a patient's mind.” But just in case:

Save Awareness Voices of Education 1-800-273-TALK
American Foundation for Suicide prevention: AFSP.ORG
Suicide Prevention Hotline

List of suicide hotlines by state

My aim in bringing it up here is to acknowledge that it exists and to show people that they are not alone.

First, a few statistics to illustrate how very common suicidal ideation is in Bipolar and how very profoundly it affects society. From this chart, we see total suicides per population in the world and the breakdown between males and females. An interesting thing to remember is that while dysphoria (mixed state) occurs in 49% of all patients, and is seen more frequently in women, in this table men score higher than women on suicide in every country. is a chart that shows suicide rates among the states in the USA.

Suicide.org reports that in the US in 2001 there were 30,662 self-inflicted deaths.

Citrome and Goldsberg write that “Suicide is among the top five causes of death in the United States for persons aged 5 to 44 years...about half of all suicides can be attributed to bipolar disorder.” They say that “the lifetime rate of suicide attempts in persons with bipolar disorder was 29.2%, compared with 15.9% in persons with unipolar depression and 4.2% in those with other major psychiatric disorders (excluding personality disorders).

Among Bipolar patients, those with substance abuse issues are twice as likely as those without to kill themselves(Citrome and Goldsberg). Put this next to the fact that Bipolar patients have a 60% likelihood of developing substance abuse problems and you can see this involves a lot of us. 15-50% of Cyclothymics go on to develop full blown BP1 or BP2.

I am just speculating, but it would seem to me that there is a lower rate of suicide among Cyclothymics. I haven’t been able to find any data on it. I suppose the reasoning is that if someone were to be as depressed/dysphoric as to develop suicidal ideation to such a degree that a doctor found it a threat, the diagnosis would be changed to BP1 or BP2.

A diagnosis of Cyclothymia means that a Major Depressive Episode has not occurred. The intensity of depression is lighter; however, it can be chronic. Cyclothymics are less likely to experience suicidal ideation (thinking about killing ourselves) than morbid ideation (fixating on the meaninglessness of life). Everybody thinks about death and existence, but not constantly, for weeks or months.

While we may not be plotting our exit from this world, we suffer.

Suicidal ideation comes out of depression. My psychiatrist commented once that “depression has its own biology.” This mean depression is not only a feeling of sadness, meaninglessness, hopelessness, but can also be mixed with hypomania to create what is known as a mixed state (see page here for more on the mixed state).

For me, morbid ideation comes out of exhaustion. First I go through a period of hypomania, feeling really good and being very productive. It’s all very good for a while, until I get tired of being so “up” and I try to relax, but my mind continues to race on without me. Slowly the spinning mind starts to descend, but not lose speed. The word loses its shimmer, I start to think negative things, to obsess about things that happened long ago. Then the mind descends into a more depressive state and the thoughts involve paranoia, insecurity, and on and on and on and on and on. It is exhausting. And it is when it gets exhausting that I start thinking about how I’d just like to shut my mind permanently. Just quiet. I never get so far as planning, or imagining a plan. All I know is I want escape. One of my forum mates wrote:

“I have truly had enough of this f**king shambolic roller coaster ride which is masquerading as 'life' - it feels more like a living hell.”

Another forum mate wrote about how he thinks of it:

“I wanted to make a post to talk about how thoughts of suicide let the pressure off being alive. That's what I'm telling myself when such things keep going through my mind without my asking them to, it's a way of holding back the stress of everything I feel I have to do. I have a choice, it isn't forced.”

What to do:

First, go to a doctor, preferably someone who knows about Bipolar issues. It may be a difficult thing to bring up, especially if it has been months or years since your diagnosis, but please try. Perhaps you could write down a list of symptoms that you are experiencing and slip it in with the other items and have the doctor read them. Be sure to include the term “dysphoria.”

Second, know that you are not alone. You can come to the forumand talk about ideation and ask how people deal with it, or just make contact with others in the same situation. Talking about it can break the spell and make it more bearable.

Third, please know that it is not your fault if you are having these thoughts. You are not being irrational or attention-seeking, or any other such crap. These thoughts are being generated by your brain in the depths of a depressive trough filled with dysphoria. This makes your brain lock onto an idea and chew on it like a dog with a bone. Don't pile on feelings of guilt or remorse on top of this. Get in to see a doctor and get help. Medications can help.

Fourth, choose life. One of our forum members wrote this:

“Choose Living.
Sometimes an almost impossible choice but I find the more of it you do the less difficult it is to make the choice to choose life. It is the difference between thriving and just surviving.

The choice is not just black and white but a thousand shades of gray.”

Lithium: Fictions, Facts and Fears

2008-02-17T06:21:00.000-08:00

I was surfing around Bipolar blogs last night. I found a writer that seemed interesting (here ) and saw a post that discussed Lithium. I have been taking Lithium for 8 years, so seeing an article about it written by another blogger caught my attention. The post is titled "Lithium: Bipolar Remedy or Exacerbation," which piqued my interest as 1)Lithium is not a remedy, but a treatment; and 2)Lithium is not known to exacerbate Bipolar Disorder. Quite the opposite, in fact. It is an example of the misinformation about and fear surrounding this widely-used medication. The entry starts with:

In the late 1800s it was discovered as having mood stabilizing effects but bipolar patients have different viewpoints towards this drug: Lithium. Sting, Evanescence and Kurt Cobain all wrote songs about it and their interpretations highlighted ambivalence around this drug. No one can say for sure whether this drug is the essential choice to treat bipolar disorder but it most certainly is a primary one.

There are a few things I find troublesome in this excerpt. First, BipolarLives.com tells us that Lithium was in use in the second century AD in the southwest of what is today Turkey:

From the ancients up until today, bathing in mineral pools and drinking mineral waters, have been popular treatments to promote mental as well as physical health...Who discovered lithium is a hard question to answer because so many early advocates of spas containing lithium knew the water to be beneficial, but had not isolated lithium or identified its specific link to manic depression.

Reading nineteenth century European literature it is not unusual to come upon mention of characters being sent to a spa for the waters (Tolstoy and James come to mind).

"[B]ipolar patients have different viewpoints towards this drug." This is a statement that can be accepted by everyone. But then the examples given are lyrics of songs written by people who have never been confirmed as being Bipolar. Neither Sting nor Amy Lee (of Evanescence) has made a confirming statement about it and Cobain was never formally diagnosed. Lee is quoted all over the Internet ((here, for example) as saying "It's not literal, it's not literal about the drug for me, I've never taken lithium before." She says she uses it as a metaphor for happiness. This means none can be cited as an "expert" about Bipolar or Lithium use, or Lithium use in the treatment of Bipolar.

The rest of the post quotes respectable websites and articles about Lithium, but focuses on the drug's negative side-effects. This gives the impression that this is a dangerous medication. While Lithium does have a list of side-effects, it is not longer than those for other psychotropic medications. For example, I am taking Wellbutrin, which can cause seizures if taken with alcohol. Lamictal can give you a lethal rash. Some anti-depressants come with suicide warnings.Crazymeds is a good place to go for extensive information about the medications used to treat Bipolar Disorder and their side-effects.

I think the fear surrounding Lithium is actually a projection onto the drug of the feelings people have about being diagnosed with a neurological condition. Lithium is closely associated in the popular mind with people being carted off to psych wards or stumbling around in a heavy stupor. I think for a lot of people it translates (however subconsciously) into a kind of "Lithium takers are REALLY CRAZY; I can't take that. If I take another drug, like Neurotonin or Abilify, then I'm not REALLY CRAZY." If they slapped a different name on it, people probably wouldn't balk when told they needed it.

Lithium is the med with the longest track record. Another thing that sets it apart from all of the other mood stabilizers is that it has been shown in extensive testing to reduce the risk of suicide, which is considerable because as many as 25 percent of severely depressed or manic-depressive patients take their own lives. Some people may have a negative reaction to it, but some people have reactions to any medications. My feeling is that Lithium has a bad rap because it was the only med for many years-- it carries the stigma of serious manic-depression-- whereas the others don't. The fact remains, however, that Lithium remains among the leading treatments. And don't forget that anti-suicide effect.

Gender difference in seratonin production

2008-02-14T22:10:00.000-08:00

A study in seratonin production levels in men and women conducted in Sweden has found that "the brain’s serotonin system differs between men and women. The scientists who conducted the study think that they have found one of the reasons why depression and chronic anxiety are more common in women than in men."

women have a greater number of the most common serotonin receptors than men. They also show that women have lower levels of the protein that transports serotonin back into the nerve cells that secrete it. It is this protein that the most common antidepressants block

What I get from this (feel free to correct me): Seratonin is a neurotransmitter that is secreted by the brain and has a great influence on mood . The substance is secreted by the brain and then reabsorbed (which is called reuptake). The slower the reuptake, the more time the serotonin is allowed to do its job-- which is why most antidepressants are designed to inhibit the reuptake of this neurotransmitter (they are called SSRI-- Selective serotonin reuptake inhibitors). If women have a difference from men (the usual subjects of med trials) then there is a difference in how the anti-depressants interact with the flow of serotonin. Anti-depressants could be modified to better deal with depression and anxiety in women.

In the brain, messages are passed between two nerve cells via a synapse, a small gap between the cells. The cell that sends the information releases neurotransmitters (of which serotonin is one) into that gap. The neurotransmitters are then recognized by receptors on the surface of the recipient (postsynaptic) cell, which upon this stimulation, in turn, relays the signal. About 10% of the neurotransmitters are lost in this process; the other 90% are released from the receptors and taken up again by monoamine transporters into the sending (presynaptic) cell (a process called reuptake).

Some theories link depression to a lack of stimulation of the recipient neuron at a synapse[citation needed]. To stimulate the recipient cell, SSRIs inhibit the reuptake of serotonin. As a result, the serotonin stays in the synaptic gap longer than it normally would, and may be recognized again (and again) by the receptors of the recipient cell, stimulating it."(see SSRIs.

Bipolar and Bruxism

2008-02-14T04:30:00.000-08:00

Bruxism is a term used to describe grinding of the teeth accompanied by clenched jaw. I was reading up on Bipolar and dental care because of my dry mouth syndrome and saw mention of this along with a note that it is common among people who are Bipolar. It involves teeth clenching and grinding during the day or night, which according to one site can cause

1. cracks in the teeth, necessitating root canals and crowns
2. jaw pain
3. headaches

I did this when I was going through grad school. My husband said the noise was frightening. I haven't had it as a result of meds, but I think with an estimated 5.7 million people under treatment for BP in the US alone, it's worth mentioning.

Medications frequently prescribed for Bipolar can also cause Bruxism. The following list is given at Contemporary Oral Hygiene.com:

venlafaxine hydrochloride (Effexor, Wyeth Pharmaceuticals),
Haldol (Ortho-McNeil Pharmaceutical),
Fluvoxamine (Luvox, Solvay Pharmaceuticals),
paxoxetine hydrochloride (Paxil, GlaxoSmithKline),
fluoxetine hydrochloride (Prozac, Eli Lilly), and
sertraline hydrochloride (Zoloft, Pfizer Inc).

Patients experiencing this condition may need dental interventions such as nightguards to alleviate the discomfort associated with bruxism

The mayoclinic.com site says

In adults, psychological factors seem to be associated with bruxism, including:

* Anxiety, stress or tension
* Suppressed anger or frustration
* Aggressive, competitive or hyperactive personality type

I should think that bruxism would be an outcome of dysphoria (mixed state, agitated depression), the main symptoms of which are "agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid and/or suicidal ideation, panic, paranoia, pressured speech and rage" (source.

Treatment.
Most dental care websites first recommend that the patient relax. (Web page writers have obviously never been in a dysphoric state). Next is the fitting of a plastic mouth guard to be worn at night. In extreme cases an experimental approach is injecting Botulinum toxin. Autohypnosis in conjunction with counseling is also recommended.

If you grind your teeth at night (and how would you know unless someone told you?), seek help immediately as it can cause permanent and catastrophic damage to your teeth and jaw.

Travelling

2008-02-13T06:15:00.000-08:00

I just got back from five days in London with my daughter (she's 15). We had a great time. Mostly we shopped and walked and walked. Loved the street culture and listening to people talk. I was surprised during our time on the Underground, sometimes at packed rush hour, how calm I was. Most of my life I have had a difficult time in crowds. I became overwhelmed quickly and withdrawn, had to take Xanax for plane flights- not because I am afraid of flying but because of the crowdedness-- and didn't like sightseeing because I could not count on being in the mood to do the things I had planned while excited (hypomanic).

But this time everything was fine. No, it was GREAT!

THIS is the goal of treatment with meds: a full range of feelings, enough energy to walk seven hours a day, an optimistic attitude, curiosity about things and people, not getting bothered by the little stuff...and not getting too wound up about it. It was a triumph, in medical terms.
I am home now. Not manic, not crashed. Just fine. Physically exhausted-- my feet are killing me.
The funny part of our trip was that we stayed with a friend who is a doctor specializing in psychiatry. I have never mentioned my Cyclothymia, just because I don't know her that well. She is engaged to my nephew. She had to complete an application to qualify for a program she desperately wants to make her career (psychoanalysis) and was paralyzed with doubt-- so I talked her through the whole process (I don't know if I mentioned that I am an academic editor and do just this kind of coaching all the time), read and edited her essays and she submitted it the morning we left. It just goes to show you that psychiatrists are people too and need support and understanding. :)

During the trip I found myself wanting to be alone-- don't get me wrong, I adore daughter and we get along great-- but I imagined how nice it would be to wander alone and just do what I wanted to do for several days. The critical idea here is that I was imagining. Before I was diagnosed and started treatment, and even for some years after that, I was unable to state anything I would want to do. I just could not fantasize, get out of my moment, rise above the tremendous BLAH that is chronic depression. This was a big moment for me, realizing that I wanted to do things by myself, for myself.

And wanting to shop. I haven't shopped for myself-- really shopped, as in "try everything on and experiment", and have FUN with clothes, in the longest time. Once upon a time, a long time ago, I was tall and slim and loved clothes. I've been apathetic about my appearance for years. I was twenty pounds over weight when I was dx'd at the end of 1999 and have gained another 30 over the last 9 years. While in London I suddenly felt like enough is enough, I want to participate in fashion again. I saw women my age with great hair in fitted tweed jackets and there I was in my baggy old sweater and jeans and my self-cut hair and, well, an enormous BELL went off in my head. Sounds stupid maybe, but it was profound for me.

When I came home and told my husband about this, he encouraged me to go back on my own soon and spend time alone doing whatever I wanted. I love that about him. He has been very supportive through all of this.

The ups and downs of socializing

2008-02-02T09:57:00.000-08:00

I had this website on a free server for seven years. This is directly related to Cyclothymia. I worried that if I had to pay for a web domain and hosting, that given my mood swings, one day I would think "What the hell am I doing?" and delete it all. Such is the wonder that is Cyclothymia. My mood swings go in weeks, so one week I'll be feeling social and creative and I'll get all kinds of things done, and then POOF! the next week I'll no longer be interested in a project in which I was completely immersed for days, and even wonder what I saw in it.

This has serious implications. For example, I run two websites at work. Both need to redesigning and updating. I started working on one and was busy with it for days and made a lot of progress. I told people it would be up by such and such a date...but then POOF! The date passed a week ago-- thankfully the old sites are up and functioning or this would be embarrassing.

Or a good friend, the one who lent me her horse yesterday, asked me if I had time for a coffee after my ride. I was horrified by the idea-- actually I couldn't do it because I had to do some things with my daughter--but at other times I have really enjoyed this woman. I felt bad. Guilty. Emotionally stunted. I have few "real" friends. Usually I don't notice this very much, but when I hit a downswing, all of a sudden it is very noticeable. I always think "what the hell is wrong with me?" Fortunately I have online friends from whom I can hide my reality better (ha!) and the the forum, where all mood sins are forgiven. I have a great many warm acquaintanceships, but let few people in farther than that...because I forget that they to have a friend you have to be a friend. I forget to call. maybe don't see a friend for six months-- because it just didn't occur to me to keep in contact.

When I was in my teens and twenties I used to put a lot of effort into socializing. I didn't always choose the most appropriate friends because I was caught up in my own struggle just to be there, and could not assess them as they should have been. I sat for two years with an incredibly self-centered, highly talkative woman just because our girls were little and they were friends and had play dates. I would sit and listen to her go on an on, whingeing about life-- but I mostly was hanging on by my fingernails then and just relieved I was actually socializing. Two years into this relationship she stopped and noted I was sometimes talkative, sometimes not, and I said I was manic-depressive and glad she had noticed after two years...not long after that her husband asked for a divorce and she moved away, and I resolved to only make friends if they were actually friends. No more hanging out and torturing myself just to be social because I thought I should.

I now have a few friends. One is a colleague at work who also studied history and is dark and funny. Another is this horse friend, who is sunny and loud. That we have passions in common makes it easier to be with them, but still the relationships are tenuous.

I am very close with my husband and daughter. I was very close with my father (he died). I have a ten-year relationship with a group of women I met online 10 years ago. I actually run that group's forum and take care of the tech stuff, by which I mean I am an active, central member. I also have the Cyclothymia forum here, and enjoy that tremendously. So it is not that I do not like to socialize, just that I like it in small doses and on topics to which I can relate. I like the Cyclothymia forum best because I can go there no matter what my mood and it really does not matter. I can just be me, by which I mean I can talk about my neurology and meds all I want.

We have nearly 7000 posts on the forum. This is what made me decide to commit to a domain name. I felt it was time to honor the group and try to reach out to more people through a blog format. I hope other people will beas helped by the site and forum as I have been.

Xerostomia (very Dry Mouth)

2008-01-28T09:11:00.000-08:00

Before I added Wellbutrin to my meds in late December, I went to the dentist, who told me I have an unusually dry mouth and that I should chew gum to stimulate the salivary glands. Not enough saliva can lead to all kinds of dental problems, including more cavities and gum disease. So I started chewing gum.

An interesting thing happened: my chronic gastritis went away almost immediately when I was chewing gum. I had been having stomach issues since about a year ago, and had tried proton pump inhibitors, which worked for a bit. In October I was hospitalized with an acute localized infection in my intestines. They did an MRI, among other things, and said it was brought on by stress and that other than that my digestive tract was fine. Four days on an IV with antibiotics and I went home and went about my business.

Then came the dentist and the comment. Thing is,

I hate chewing gum.

So I started looking around at other things to do to relieve the dry mouth, and help my stomach. I came across xerostomia, which is basically dry mouth, and learned that prescription drugs can cause it. So then I looked online at my lithium and then at the Wellbutrin. Both can cause dry mouth.

After a month of Wellbutrin + Lithium, my gastritis was back almost any time I was not chewing gum,which brings u p the idea of synergism, two or more drugs combining and having an amplified effect. I don't want to stop the meds, obviously, but especially since I am feeling the best I have in 7 years.

Treatments are increasing water intake, to keep water by your bed because at night saliva production comes nearly to a stop. Suck on sugarless mints, eat sour things, cut out caffeine as it is a diuretic...

So three days into this, I am feeling MUCH better. Whenever I notice my mouth is dry, I stop and imagine something really sour. I sip more water.

So far so good.

What I like is this: treating a problem from its source (Dry mouth) rather than from its outcome (gastritis). It's like with an anti--depressant and Xanax. The AD works on the reabsorption of neurotransmitters whereas Xanax is taken "as needed", to treat the outcome.

Pilocarpine and cevimeline are drugs that stimulate saliva. Online directions say 3-4 pills a day ought to do it. So nowI am debating what to do, buy stock in gum companies or add more ppill to my regimen.

Importance of sleep for stable brain function

2008-01-26T07:43:00.000-08:00

An article on the importance of sleep for stable brain function is presented by Live Science

"Emotions Run Amok in Sleep-Deprived Brains" by Charles Q. Choi, Special to LiveScience, full findings available in 23 October Journal Current Biology.

Many psychiatric disorders, "particularly ones involving emotions, seem to be linked with abnormal sleep," he added. "Traditionally people mostly thought the psychiatric disorders were contributing to the sleep abnormalities, but of course it could be the other way around. If we can find out which parts of sleep are most key to emotional stability, we already have a good range of drugs that can push and pull at these kinds of sleep and maybe help treat certain kinds of psychiatric conditions."

I agree with this. Whether or not I have got 7-8 hours of sleep greatly influences my day. When I am hypomanic or dysphoric and starting to become too wound-up to sleep, now one of the first things I do is clamp down on the sleep. I have put a fan by side of the bed (for the constant noise) and we installed shutters on the windows that block out light completely last summer. It made a big difference, not just to my sleep but to that of my husband. He will turn on the fan of he goes to bed before me. We live in a neighborhood with a couple of bars that let out drunk people at all hours who can be very noisy. Sometimes they decide the best place to sit and have a drunken discussion about the meaning of life below out window. Now we do not hear these.

I have also learned to embrace napping. I used to get mad at myself for falling asleep and wasting time, but now I know the more sleep I get, the better I will feel. I love a nicelittlenap after I have walked the mile home from work.

Mood Tracking Charts

2008-01-26T06:57:00.000-08:00

Free of Charge

Bipolar Clinic and Research Program at Massachusettes General Hospital has a chart for tracking moods.
Moodtracker.com A place to track moods and medications. Developed by a member of the About.com BP forum.

Psychiatry24x7.com (Recommended by Gladyswink)

Psycheducation.org (Recommended by Markmeerkat)

Online Tracking Systems

Google Calendar Here is an article from Lifehacker.com on how to use Google Calendar to track mood.

Moodmill.com A social networking site where you can track moods. Now has extensions with Firefox, Facebook. Source code available at Google Code. Main drawback: no way to keep moods and notes private.

Morale-O-Meter. From the site: " anyone with a 43 Things account can set up their own Morale-O-Meter and we can compare our daily morale, health, sleep, alcoholic consumption, and caffeine intake with each other."

Commercial

Health Engage. $59-$69, for MAC, PC and handheld units.

Do-It-Yourself

Polarbear63, from forum:

a simple scale, 1-5, and write this number in the front of my day planner where it shows the whole year on 2 pages. The scale goes like this:

5 - so high, can't get any work done, laugh all the time, elated
4 - feel good, but can still work, funny and expansive
3 - level, normal
2 - occasional tears at ads on tv, somewhat low, no point to anything
1 - hide the knives, constant tears, feelings of total worthlessness

Bumble thought that did not give enough detail and posted this:

V – Auditory hallucinations (voices)
M – Metallic feeling in head
U – Ugly, feeling grotesquely fat and totally unattractive
P – Paranoid
R – Racing thoughts
I – Insomnia
H – Hyposomnia
G – Feeling gorgeous, vibrant and sexy

Su – Suicidal thoughts
Ps – Planning suicide attempt
Fl – Wanting to get out, leave, flightiness

GA – Good appetite, eaten well
BA – Bad appetite, eaten poorly
NA – No appetite, eaten hardly anything
Bi – Binging

PW – Physically well
PP – Physically poor, random aches and pains etc
PI – Physically ill, suffering with real physical ailments (Gall stones, ovarian cysts)

PS – Period Start
Bl – Bleeding
PE – Period end

I've also created a monthly calendar on excel, with the date, then a column for the mornings' rating (using the above codes) and activity column, to note briefly what I was doing on that morning. Then an afternoon rating column and activity column, the same for evening and another one for bed time... Because I often find that my state of mind switches so quickly and sometimes going to bed can trigger unhealthy thoughts.

Stacy presented this:

5 – buzzy, can't sit still for more than a few minutes, check my email every 5 minutes, hard to get work done, focus changes frequently, jittery, impulsive
4 – feeling buzzed, but work really well. hyperfocused, fast, creative and expansive, beat deadlines, life is great
3 – not fabulous, not a failure, not thinking too much, can be more aware of those around me
2 – sweet and silly tears over TV ads, sort of low, worry about god and man and my faith, write poetry
1 – tears at unprovoked times in public places, feelings of worthlessness, wanting to escape the trouble of life, cant comprehend the “why” of our existence, confused, grieving something I cant see

She later posted this:

high - outside myself: bigger than the trees
mid - inside my own skin
low - folded in on myself like a cloth puppet on a stick

Here is my chart, which expresses both mood and speed of mind:

Self-Help

2008-01-26T06:37:00.000-08:00

Stability is not all up to doctors and medications. I must do everything possible to improve and maintain my stability. The following is based on my own experience:

1. Regular sleep

Research on Cyclothymia suggests that episodes are connected to disruptions in our circadian (24-hour)cycles. Before my diagnosis, sleep was never a sure thing. I would get into bed worrying about whether I would make it through the night. I often woke up at 4:00am, brain racing. Other things conspired to keep sleep erratic: our daughter didn't sleep through a whole night until she was three. We lived in an apartment with noisy neighbors. The call to prayer from the neighborhood mosque came just before dawn. My husband snores. Sometimes I'd get so caught up with writing on the computer, or surfing the Internet, I wouldn't make it to bed until one or two.

After diagnosis I started to make regular sleep a priority and soon came to agree that it is the cornerstone of stability. It was a little difficult at first to go to be "early," but after a while I could see that the benefits far outweighed the TV I'd missed. Now sleep is THE
priority. My new rules:

1. In bed by ten with a book that will make me sleepy (no page-turners!).
2. No TV or computer after 21:00. Too stimulating. Too easy to get sucked into something and not make it bed by 1:00.
3. No caffeine after 18:00.
4. Floor fan while sleeping to mask the street noise.
5. Designated place in house where I can escape to sleep as soon as it is clear that kicking my husband will not get him to stop snoring.
6. After one night of insomnia, I take an over-the-counter sleep aid (half a Unisom) for the next few nights.
7. Chart sleep quality on a daily/nightly basis. For me this is one of the most accurate indicators of an impending mood swing.

2. Keep a Daily Mood Chart

The chart I use is simple and practical. I expanded it once, to include exercise and food intake, but it was just too much (and I felt too guilty for not filling up my exercise boxes!).

1. Makes meetings with the doctor easier.
I think it is the key to the easy working relationship I have with my doctor. I go into my appointments with it filled in. I keep track of other health stuff on the back of the page, and scrawl questions for my doctor across the bottom as I think of them between appointments. He takes it, then transposes the information to his own charts, and then we go into the details. We save 10-15 minutes by not having to rely on my memory, which is not what it used to be because of the meds.

2. Allows you to fine tune your treatment.
I have my worst months from March to mid-July. I call it "Reverse SAD" (Seasonal Affective Disorder). Before my diagnosis, this was kind of a joke, but now into my fifth season with the charts, it is clearly a very real pattern and this last year my doctor has adjusted his approach accordingly. One blanket treatment does not fit all.

4. Track medication intake and progress over time.
I have been taking 900mg of Lithium since the beginning, but my use of other meds has varied. I suffer from GAD-like symptoms (Generalized Anxiety Disorder) from time to time, so I take Xanax as needed. Where I used to take it a few times a week, now I am down to mainly summertime use. I can see my progress. Tracking my intake of over-the-counter sleep aids has convinced me that early action can shorten a hypomanic episode-- and the crash that follows-- by several days. Recently I stopped one within 24 hours and skipped the crash altogether. Victory is sweet!

3. Join a support group

It will remind you that you are not alone and help you to stay on top of the latest developments in treatment. You might even make a friend or two. Support groups for Cyclothymia are rare-- but it doesn't have to stay that way! We can start them in our own cities, create our own email lists, set up our own web forums. For starters, stop in at the forum here and say hello!

4. Regular Exercise

When someone figures out how to accomplish this one, let me know! Before diagnosis I used to workout to provide self-esteem through goal setting, to blow off steam, or to stimulate endorphins to help during depressions. Lithium has made me lethargic and unable to really REMEMBER what all the fuss was about-- which is a great blessing in one sense (I used to obsess endlessly about past events), but otherwise is turning into a troublesome issue since I have gained about twenty pounds in the last two years. I have started horseback riding several times a week, something I never imagined I would be doing again, and which I credit my medications with making me able to even conceive of being able to do. This brings me great joy and is helping me with body awareness. Hopefully this will translate into a will to get fit again.

Welcome

2008-01-24T11:40:00.000-08:00

Welcome to the new home of The Cyclothymia Collective website. After eight years (1), I have decided to commit and buy a domain name and get rid of all of those atrocious advertisements. Right now I am in the process of transferring data and creating a design, so please don't mind the mess.

The address for the forum remains the same. The forum is my favorite part of the site, and my favorite part of the whole experience of having a website and forum about cyclothymia. Lots of great people, interesting stories and answers to all kinds of questions. There are more than 6000 posts, and that is not counting the posts that remain at our original forum site.

On this site I plan to have the original information, updated and expanded, and to add new pages. I also want to run a blog, and to participate more in the Bipolar web world. For example, now that the site has no advertisements, some of the more serious web sites will link to it (hopefully).

The site has no comments section for now. I would like comments to go in the Forum.

Stories/ Susi

2008-01-23T06:01:00.000-08:00

Cyclosusi

Cyclosusi is the author of the Glossary of BP Terms. This autobiography was submitted in Spring 2005.

Although I was diagnosed as cyclothymic only six months ago, the pattern has been there for 40 years or longer.

I was born in London in 1952. As a child I was a loner, but not lonely. I excelled in all things academic and was considered sensible. I first experienced depression around age 13, but my doctor considered this insignificant. After studying languages and secretarial skills at college, I worked in several office environments. I excelled at work for which I was praised. Late teens/early twenties I had a few friends but preferred my own company, often singing/strumming in my bedroom. I frequently felt depressed. I felt confident in the work place, but uncomfortable in social settings. My depression seemed to come and go in cycles. I self-medicated with alchohol. My depression appeared unlinked to external circumstances.

At 28, I married, and had an instant family of a boy of 4 and a girl of 2. I gave birth to a daughter at age 29, and another at 39. Cycles of depression, lack of confidence and crying alternated with periods of high achievement, and elation. In addition to raising my family of 4, I worked part-time, mainly in social welfare.

At the age of 49 I was promoted over 15 staff to run a 24x7 social welfare service. I loved this environment, I transformed the service and gave it my all. However, following a change in management at a higher level, recruitment was halted, resulting in me covering adviser shifts in addition to my own job. I woke up one day, unable to cope. I felt the worst I had felt in my life. I was exhausted, depressed, crying continually, lethargic and had zero confidence. I slept 23 hours out of 24. My doctor advised total rest and prescribed antidepressants. It took several weeks for the crying to ease, the total depression and lethargy decreased after a year. Gradually over the next year I could cope a little better. I attended therapy sessions, where I first heard the words Òdysthymia and cyclothymiaÓ.

In January 2004 I was reading a magazine on mood disorders. There was no mention of cyclothymia in the article, but I felt I related to the explanation of bi-polar disorder, although my highs weren't as high, nor my lows so low. I discussed this with my doctor. She agreed I should see a psychiatrist. In September 2004, I saw a psychiatrist for the first time. I poured out my life history. In addition to the previous 2 years of total breakdown, she diagnosed cyclothymia. I was already taking fluoxetine (prozac) and she recommended I continue to take 40mg per day, but reduce the dose to 20mg on days I felt "high". Finding the Cyclothymia Collective is the best Internet search I ever made.

As the major family breadwinner, now without income, we sold our house on the south coast of England and moved into our 150 year old holiday cottage up a mountain track in the south of Ireland. My husband will be renovating and extending this over the next few years.
Susi now (March 2005 )
I still haven't recovered fully from my breakdown, but now there are up days as well as down ones. When I am low, I find it difficult even to cope with basic living. When I am high; well, that's another matter. I love music, old cottages, the countryside, wild flowers, family history, my children, my grandchildren, making furnishings, the Internet, helping people and Victoriana. My prize possession is a 12-piece tea set which was a wedding present to my maternal great-grandparents in 1888.

It is my intention to return to the studying I had begun 3 years ago. I have registered with the Open University and commenced a course in Nutrition and Health. I don't care how long this takes, as my 100% now is less than my former 50%. Hopefully I can accept this and be content with what I do achieve.

Susi

About the site: Disclaimer

2008-01-23T05:59:00.000-08:00

About the Site

The Cyclothymia Collective is a personal site created as a place to collect and share information about Cyclothymia, a "mild" form of Bipolar Disorder. I am not a medical
specialist of any sort. The information on this website is my interpretation of what I have read on Cyclothymia. I am pro-medication, only because I spent about 25 years struggling on my own in an increasingly uphill battle with my nerves, insisting I could do it, only to have my nerves win out....but alternative treatments and discussion of them are given ample space in the forums.

Today I went back to the original forum, from 2001 and read posts, I hadn't read them in a log time. I was immediately struck by how much I have grown, and how much I have learned. I feel a great deal of this has come from participating in the forum. The support and kindness shown by the people who frequent the forum are wonderful.

About Me

I was born in 1963 and grew up in the Pacific Northwest. I have a BA and MA in social history. I like to write and organize things. I work as an editor of academic texts and run an editing office for a research institute. I first realized something was not right with my moods when I was fourteen and then spent the next 25 years thinking that hypomanic me was the "real" me and my depression and dysphoria a result of my inability to implement techniques of CBT. In my late 30s I was diagnosed with Cyclothymia. At that time, in 2000, there was almost nothing on the Web about Cyclothymia. I decided to create a place where I could collect information about it and share it with people like me.

I have come to understand that my breakdown was one of the best things that ever happened to me. I don't like taking medications, I doubt anyone does, but they have freed me from the prison om my moods. My rate of creative production has exploded. I am writing my fourth novel in a little over two years. See my post on Creativity and Lithium.

There is life after diagnosis. It is a difficult road, and we don't really have a choice about it, so we may as well make the best of it. Together.

Why I have the comments turned off: I am Cyclothymic. This means I have days when I can deal with things and days that I can't. A lot of days I can't deal with managing comments. It makes me want to shut down the site. My solution is to ask that all comments and questions be taken into the forum. If I'm not up to it, then other people can help. :)

BP Blinkies,Web stickers

2008-01-23T05:55:00.000-08:00

Graphics

These are blinkies, Internet stickers, and blogstickers related to BP and mental health I've run across while surfing around in 2004. I did not make them. All are freeware, meaning you can take them without a second thought. Right click on your mouse to download to your desktop, then upload to your site or email.

Do not link directly to this page!!

Added 3 March 2005:

Blogstickers (from Blogstickers.com)

Blinkies (Blinkie Obsession for a massive list of links to blinkie sites)

Internet bumperstickers (all from internetbumperstickers.com )

Mood Factor stickers, for use in forums

Mood Factor is measured on a scale of 1-10 as follows:

	Too happy. Need to see doctor.
	Very happy, hyper, energized, talking non-stop, pressured speech, racing thoughts, big plans!
	Slightly elevated mood. Everything, everyone seems acceptable. Very efficient and, talkative, funny.
	A balanced mood, productivity but no obsession. Socializing effortless. Life is okay.
	Kinda of depressed, blue.
	Depressed, blah, perhaps a mixed state.
	Very depressed. Morbid ideation. Life seems hopeless. Need to see doctor.

Glossary of BP Terms

2008-01-23T05:54:00.000-08:00

A Glossary of BP Terms

This glossary of Bipolar Terms was written by Soosi of London in
January 2005. If you can think of some other terms that will help
people navigate this medical maze, leave a message in the
Administration section of the forum.

The contributors to this glossary (site) are not medically trained; we are sufferers of cyclothymia who wish to offer support to others who have been diagnosed with cyclothymia and their family/friends. Individuals should consult their medical doctor or psychiatrist before trying any alternative treatments/suggestions or for a fuller explanation of any of these terms. (Soosi of London)

Term	Definition, other words used
Antidepressant e.g. Prozac	A treatment (e.g. drug) that helps to raise the mood of a depressed person.
Anxiety Tension	An unpleasant emotional state; worry about unreal or imagined danger resulting in psychological (e.g. tension) and/or physical (e.g. sweating, increased heart-rate, fatigue) symptoms.
Beeper	Someone with BP.
Bi-polar Disorder	BP; BP1. BP2.
Manic Depression, MD	A mood condition, formerly called manic-depression, where your moods can swing from very high (mania) to very low (depression). The high and low phases of the illness are called ï¿½episodesï¿½ and can be so extreme that they can interfere with your daily life.
Bi-polar Spectrum BP Spectrum	The bipolar spectrum incorporates all the bipolar disorders (e.g. bipolar disorder, cyclothymia). The word 'bipolar' means having two poles or extremes - in other words sufferers of these disorders suffer both highs (mania or hypomania) and lows (major depressive episodes) and also mixed episodes.
BP	Bipolar Disorder.
Cyclothymia	BP3; A mood condition, where your moods can swing from periods of very high (mania) to periods of very low (depression) (known as ï¿½episodesï¿½) which can be so extreme that they can interfere with your daily life but not to the degree that occurs in Bipolar Disorder.
Depression	Low; down A mood condition where you feel sad, low, inadequate, discouraged usually resulting in a slowing down of activities.
Derealisation	A change in your perception of the environment such that things that are normally familiar seem strange, unreal, or two-dimensional.
Depersonalisation	A change in your perception of yourself so that the usual sense of your own reality is lost, manifested in a sense of unreality or self estrangement, in changes of body image, or in a feeling that you do not control your own actions and speech.
Euphoria	Very high. An exaggerated feeling of physical and mental well being. Feeling very happy, usually resulting in an increase of activity.
Episode	The high and low phases of Bipolar Disorder and cyclothymia.
Hypomania	High (but less than mania). A higher than normal mood resembling mania but of lesser intensity.
Ideation	The formation of ideas or thoughts.
Mania	Very high. A mood condition where you feel very happy and/or agitated, having high self-esteem and usually resulting in an increase of activity. Mania may affect thinking, judgment, and social behaviour.
Manic Depression, MD	The old name for Bipolar Disorder.
Mixed Episode	Experiencing some symptoms of high episodes and low episodes at the same time.
Morbid ideation	The formation of morbid ideas or thoughts.
Mood swing	A person's emotional feelings switching from high to low/low to high.
Mood stabiliser e.g. lithium	A treatment (e.g. drug) that helps to lift mood in depression and lower mood in mania, without provoking switching to the other side.
Psychiatrist, Psych doc, Pdoc	A doctor who specialises in the diagnosis and treatment of behaviour conditions and mental disorders.
Psychotherapy, Therapy	The treatment of mental illness or emotional disorders mainly by communication (e.g. talking/listening).
Rapid Cycling	Switching from high to low/low to high episodes in quick succession
Self-Medication	Use of unprescribed substances such as drugs or alcohol to alleviate symptoms of a disorder
Therapist, Tdoc	One professionally trained and/or skilled in the practice of a particular type of therapy(treatment).

The Mixed State (Dysphoria)

2008-01-23T05:53:00.000-08:00

A mixed state is when symptoms of mania and depression are present at the same time, so you have the over-active brain of hypomania with symptoms of depression, a racing mind churning with negativity.

The mixed state is the most dangerous phase of Bipolar Disorder because a common feature is suicidal ideation (thinking about death/suicide). This is where the high suicide rate (said to be something like 20% for people with Bipolar Disorder compared to 1-2% for the general population) and the high rate of substance abuse (said to be more than 60% for people with BP) come in.

For me, the mixed state comes at the tail end of the cycle. First, I become hypomanic over the course of a couple of weeks). Everything is fun and interesting and I'm very productive and social. I don't realize I'm hypomanic for some time- I just think I am "the old me/the real me." My mind stays racing along, but then my mood plummets. I am irritated by noises, get angry when driving, begin to think life is stupid, that everyone is stupid, and that it is all for nothing.

This is the Mixed State. It can continue for days, or weeks. It gets very tiring, very frustrating, and it gets boring, not being able to switch out of this mood. This is where substance abuse and thoughts of life-ending come in-- what better way to get my brain to SHUT UP....I have never had actual suicidal thoughts, just vague fantasies about the relief of not having thoughts anymore. Eventually there comes the crash, a fall into depression. My mind is still, but it is painful and I spend weeks crawling out of it and pulling myself together.

I then go through a period of feeling shaken by my experience. I have just spent weeks intensely questioning everything, looking for answers, looking for relief. I must rebuild my life, from the inside out. Often I feel residual surprise, disappointment, anger, embarrassment, frustration that I go through such a cycle, that I need to see a doctor. I don't want to see anyone, I don't want to do anything. Gradually I recover, but it takes time for the memory of all that negativity to pass.

Following is a list of symptoms, arranged alphabetically, thatare often given for Bipolar disorder. To the right are my experience with how they feel to me. You may experience some of them, but not others, or you may feel them more intensely. Or not. If you can think of some I haven't listed, let me know and I'll add them. Always let your doctor know if you are experiencing
any of these feelings. Adjustments to your med regime really can reduce suffering.

Agitation
Feel like there is electricity coursing through my body at an even rate. I can't shut it off. Have to keep moving, can't settle down.

Anger
Feel like I am going to fly off the handle at the slightest little thing. This makes me paranoid that I am going to do something I will regret.

Anxiety
For no specific reason, I feel like something horrible is going to happen at any moment, even though I know perfectly well that everything is okay. I call it "Chicken Little Syndrome," this feeling of impending doom. It's like the switch in the brain that signals crises is stuck.

Appetite changes
Eating too much, or eating too little.It's like I am trying to medicate myself with food: "If
I just eat x, then this feeling will go away...."

Delusions of failure<
Am convinced that my life is a failure, that my marriage is not what it seems, that my boss is going to decide I'm incompetent, and I feel like crying because I have no friends. No evidence supports any of this. In fact, the reality is quite the opposite. I am successful and loved.

Destructive
I do things that I know are bad, like smoking and drinking. I drive a little too fast. I hurt my relationships, I tear my cuticles, I cut my hair impulsively, especially if I feel anxious.

Fatigue
From not being able to sleep, and then being too tired to sleep.

Fear<
Having a racing mind full of anger, paranoia, anxiety and self-loathing is frightening in the immediate sense (what if I lose control and say or do something that will ruin my life?), but also in the long-term sense (what if I completely lose control and end up institutionalized?).

Feeling "on edge"
For me it's like my engine is idling at too high a rate, almost like a vibration in the background, and that any minute the thing is going to shake apart.

Guilt
I feel responsible for everything, even mean comments I made thirty years ago, every failed
plan. I become filled with regret and embarrassment and replay those old scenes endlessly.

Increased libido
(but not necessarily out of positive feelings)

Impatience
This goes along with "feeling on edge", I'm hopped up, I'm ready, what the hell is wrong with
you? Can't you see the light is GREEN? Road rage figures in here.

Impulsiveness
Every February I buy clothes I never wear during a bouts of "retail therapy", and get my hair cut very short. I buy books on obscure topics to impress myself, and start creating websites I won't follow through on.

Insomnia
My brand is morning insomnia, waking up, wired at 4:30-5:00.

Irritability
Grrrr...what did you say? I know I am irritable when the street noise outside our urban house begins to really bother me. I think everyone is stupid, including myself, being civil takes nerves of steel. Road rage figures in here, too.

Melodrama
No one has EVER been depressed like I have...oh, woe is me...Small things get blown way out of proportion.

Mind racing
Manic mind stuck in a long rut of negativity, mulling over bad moments, making plans
to get out. I get so tired of this. Just SHUT UP already! It's exhausting.

Morbid ideation
Thinking about death and existence. Not necessarily about suicide, although it can be. Can be about how good it will be to pass out of this existence, how everyone in the past has died, how I will die too, how none of it is important because the worms will get us all in the end. Everybody thinks about death and existence, but not constantly, for weeks or months.

Panic
Along with the general feeling of heightened anxiety, there is a specific impulse that I must be ready to flee. Some people have all-out panic attacks with adrenaline and racing heart.

Paranoia
I feel like everybody is looking at me- in a bad way. I make little jokes to my husband about him and other women (which otherwise does not occur to me). At work I suspect office politics are going against me. For none of these is there any evidence.=Pressured speech

Pressured Speech
I feel like I must speak. I bombard my husband at the breakfast table with sociological
observations (when I know perfectly well his brain is incapable ofaccepting information until he's finished his coffee). Sometimes it's pressured, angry speech, like when I feel compelled to lecture
strangers about their bad behavior. My husband calls it a "Pandora's box" moment.

Rage
With all this negative energy coursing through my body, I feel like I am going to explode
at any little thing. Driving is a challenge: everyone is an idiot.

Weeping
Feeling anxiety, guilt, anger, panic, and fear for my mental state, I cry easily and often.

Do you have bouts of mixed state? Want to talk about it? Come over to the Forum and join the discussion.

2008-01-23T05:52:00.001-08:00

Treatment

2008-01-23T05:49:00.002-08:00

The Kindling Effect

If you are resisting going on-- or staying on-- medications, please
take a moment to consider a phenomenon known as The Kindling Effect.
Each depressive/dysphoric or hypomanic/manic episode is worse than the
previous one. With time, the small flame eventually can become a
roaring bonfire. Treatment with mood stabilizers can slow down that
development, or maybe even stop it.

Statistically, for up to half of us (15-50%), Cyclothymia is only a
staging ground. A full half of us will go on to develop full-blown BPI
or BPII. And it is not at all clear which of us this will be.
Conscientious treatment with therapy, medications, and behavioral
changes can reduce the number and intensity of episodes and reduce our
chances of things getting much worse.

Like its definition, the treatment for Cyclothymia is by no means
standardized. Before 1980, Cyclothymia was classified as a personality
disorder and treated mostly with talk therapy. In the 1980s it was
officially classified as part of the Bipolar spectrum and work began on
seeing if Cyclothymics respond positively to mood stabilizers. Most of
the websites list talk therapy and/or medications as the treatments of
choice.

Talk Therapy

Since interpersonal problems are common in
Cyclothymia, given the "I must talk to everyone/I must talk to no one"
mood swings, as are irritability and a host of other really pleasant
quirks, therapy often focuses on behavioral techniques for more
satisfying social interaction. Cognitive therapy such as Rational
Emotive Therapy teaches you how to identify and overcome irrational
thinking. Other therapies might focus on family interaction, dealing
with workplace stress, or "comorbid" issues such as substance abuse,
spousal abuse, and other life traumas.

Medications

While Lithium seems to be most often listed as
the mood stabilizer used, it is joined by the other medications given
for Bipolar such as Depakote, Lamictal, Tegretol, or Topamax.

Successful treatment happens when we take responsibility for our condition.

Diagnosis

2008-01-23T05:49:00.001-08:00

As much as doctors wish we wouldn't, we do like to diagnose ourselves. I knew I had some form of Bipolar Disorder for almost 20 years before I sought formal care. From 1992 I had Internet access, so I knew what was wrong with me more or less, and was trying to cope with my mood swings through fitness, healthy eating, behavior modification, meditation, and Benadryl.

Getting help

What kept me from seeking out help? Well, I did seek out help, but from the wrong people. In high school, my parents and the family doctor said it was just adolescence and "attention-seeking." When I approached a beloved teacher about feeling I was fundamentally different from other people, he said, "We all feel that way."

When I got to college and described my feelings to the student health center's general practioner, he winked at me and said I needed to have my boyfriend give me a massage. When I went to the Counseling Center to ask for help because I was unable to tolerate my room mates, the psychologist on duty laughed and told me that a woman with my appearance, social skills, and family background could not possibly have any problems!! A month before graduation, the Women's Health Center's nurse practitioner diagnosed it correctly as "borderline manic-depression" (back then there was no classification for Cyclothymia), but suggested I try going back on the Pill.

When I was in grad school, I talked it over with my dad, who was a counseling psychology professor. He was adament that mood could be overcome with correct thinking (he was into Rational Emotive Therapy ). When, a few months before I was finally forced by my body to find help, I asked a good friend of mine, a professor of neurology, about mood swings and seasonal fluctuations, he dismissed them, saying that SAD is a sub-group of manic-depressive disorder and that I in no way
met any of the criteria for manic-depression.

Know who and what you need

My point with all this is that you can approach all the people you wantabout it, even highly trained professionals in the mental health field,but if you do not know exactly what kind of doctor you need to see-- one who will know what you are talking about and, more important, take it seriously-- you are unlikely to get the help you need.

When my low-grade depression began to produce a feeling of constant anxiety, what I call "Chicken Little Syndrome," and I began to be unable to recover from meltdowns, I sought help. This time I contacted a psychopharmacologist whose special interest is Bipolar Disorder. (A psychopharmacologist specializes in medications, unlike other psychiatrists who might specialize in therapy, or a mixture of therapy and medications.)

Go in prepared

Before I went in for our first meeting, I sat down and made a timeline of my mood swings, starting fromthe beginninng (about age 14). I also took an online depression test. Doctors may roll their eyes at these, but as the tests ask the same questions the doctors do when taking an inventory of symptoms, I think it's good to have the list, with any comments you want to make written in the margins, going into the meeting. Because I had my history all written out, I was able to present my case with all the details, which I might not otherwise have been able to do given my miserable state. It's hard to confess everything to a stranger through a face full of tissues. And doubly hard if you have to admit to having constant thoughts about the point of your existence. He read everything while I emptied his tissue container. =

It was a strange moment. I felt like I was an outlaw on the run finally come into town with my hands up. I was too frazzled to go on with it, and very willing to have the burden removed, or at least alleviated, even if it meant "giving in" to medications. He diagnosed me as being "Cyclothymic with BPII tendency," which means I have some hyper moments, but mostly am fighting low-grade depression and dysphoria (irritable hypomania, or mixed state).

Go directly to a psychiatrist or psychopharmacologist if you think you have Cyclothymia. A counselor or psychologist may be able to help youwith the behavioral aspects of Cyclothymia or side issues that might be making it worse, but such professionals are unable to prescribemedications, and --as in my case-- may even tell you that medications are unnecessary. Your chances of reestablishing some sort of normalcy in life are much greater if you seek out a psychiatrist who 1) believes Cyclothymia exists, and 2) knows what to do about it.

What is cyclothymia?

2008-01-23T05:44:00.000-08:00

The modern concepts of mood disorders and a bipolar spectrum first emerged in France in the mid-nineteenth century. The term "dysthymia" (depressed temperament) appeared in the psychiatric literature as early as 1844, and "cyclothymia" (cycling temperament) in 1877. Scholarly debate focused on these two and a third, called hyperthymia (manic temperament).

In 1889, all known affective disorders were lumped into one category called "manic-depressive insanity." This practice of viewing the entire bipolar spectrum as one entity became so widely accepted that the term "dysthymia" was all but forgotten and "cyclothymia" came to be used to describe any bipolar case.

In the 1960s, research established that real differences exist between depression, mania, and their variations. In the early 1980s, "dysthymia" and "cyclothymia" were reintroduced, along with the concept of the bipolar spectrum. Perhaps because of its relation to major depressive disorder, dysthymia has received much more attention from researchers than cyclothymia, which remains poorly understood except as a precursor to Bipolar Disorder. Disagreement exists on what the term even means. Some use it as a description of temperament, others, as a synonym for Bipolar Disorder, and still others as the term for a subaffective disorder. This last meaning is the one used by the DSM-IV and the World Health Organization's ICD-10. Several of the abstracts on Cyclothymia available at Medline argue for the third usage only. So it is no wonder that there is no one understanding or one treatment for Cyclothymia.

Where to look for information

There are many sites on the web with the basic information, such as the official DSMV-IV classification and translations of that into everyday language. Perplexingly, most of the sites repeat other sites, almost word for word. I won't do that here. I'll just point you to what I think are the best of the Cyclothymia sites:

McMan's Depression and Bipolar Web .
He gives the DSMV-IV, plus a list of symptoms, plus a fictionalized passage with an account of life with Cyclothymia, and best of all, a discussion section where people have posted their experiences with the disorder.

Psycom.net,
presents a generous list of links to sites with information relating to Cyclothymia.

Who names these disorders anyway?

Maybe the name is part of the problem of our not being taken seriously, or our reluctance to tell anyone about it.

"Cyclothymia" sounds like a being from Greek mythology with one eye who rides a unicycle. I know, I know, in Greek it means "cyclo"= cycle and "thym"= emotion...but still, in English it lacks substantiality. When you say the word to people, they say, "What?" and then you have to go into an explanation that it is part of Bipolar Disorder.

"I have Cyclothymia," you say.
"Well," your roommate comments, "you have to be careful about STDs these days."

So you take another tack:
"I have a mild form of Bipolar Disorder."
Sounds like a bear with housekeeping issues who goes both ways.

"I have BP3."
"Cool, but I thought that Star Wars character's name was "C3PO"."

How about: "I have a mild form of manic-depression," which brings to mind the stereotypical images of full blown manic episodes or suicidal depression-- scary.

One of the forum members used "BP/C" the other day. I like that.

I think maybe we could rename it "Mood Regulator Disorder"--MRD for short, or "merde" (French for "sh*t").
Then you could say, "Sometimes I just feel sh*tty."
"Man, you got that sh*t, too? That's harsh."

All joking aside, what is Cyclothymia?

This is what I understand:

Cyclothymia it is part of the Bipolar spectrum. People often come into the forum and say, "I don't know if I am Cyclothymic or Bipolar." Cyclothymia is a version of Bipolar Disorder.

It's called Bipolar III in the classification books. It is treated sometimes with talk therapy, but it is more commonly treated with serious psychotropic, mood stabilizing drugs like Lithium and Topamax. To respond to those who say that Cyclothymia is not really an illness, I say that it seems a sure indication that Cyclothymia is an illness if it requires these kinds of medications to treat it.

It might be that its symptoms are not as full blown as in BPI and BPII as to require hospitalization, for example, but it certainly disrupts our lives and causes us enough pain that we feel compelled to seek professional help and support on the Internet.

My psychiatrist says Cyclothymia is part of the BP spectrum and that a specific label for it is meaningless as everyone experiences it differently, many people go on to develop BPI or BPII later on in life, and the treatment is nearly identical to that for BPI or BPII. What is
important is to establish whether you are on the spectrum at all, not
where you are on it.

More important than if other people take you seriously is whether you take yourself seriously.

Welcome

2008-01-23T05:36:00.000-08:00

Welcome to the Cyclothymia Collective, a personal website about the neurological condition (or "mood disorder") called Cyclothymia. I started this website in 2002, roughly two years after my diagnosis and beginning of treatment. I had spent a lot of time on general Bipolar forums and felt that it was time there was a website and forum dedicated just to Cyclothymia. I felt that while we have a lot in common with people with BPI and BPII, our needs and issues are different. How are they different? Well, I wasn't exactly sure. So that's why I named the site The Collective. My aim was to create a place where people with Cyclothymia, or who thought they might have Cyclothymia, could come and add their accounts of living with this, so other people could come by and compare and contrast their own experiences and then leave their own stories, so eventually we could have a mass of experience in one place from which we could benefit as a community

The Forum

2008-01-23T05:28:00.000-08:00

The loved ones of people with Cyclothymia are also welcome to come in
and read everything. You are also welcome to participate in the forums
and ask questions as much as you like. We don't have a section
especially for loved ones simply because it hasn't been requested, but
all you need do is ask :) Environment is key for success in dealing
with Cyclothymia and environment is all about loved ones, so anything I
can do to help you understand or cope with this, just let me know.
The more we talk about Cyclothymia-- the more common ground we find--
the more shape we give to this thing. Of course, we also have a lot of
fun in the process.You can enter the forum here 
   
In September 2005 I switched to a better forum provider. The posts from the old forum are available for reading as an <a href="http://www.chatea.com/cyclothymiacollective" style=" font-weight:bold; border-bottom:2px dotted #493a1e ">archive herea>.